Irreversible electroporation for metastatic pancreatic carcinoma with liver metastasis: What does the evidence say

Abstract

Irreversible electroporation is a promising non-thermal ablation method that has been shown to increase overall survival in locally advanced pancreatic cancer in some studies. However, higher quality studies with proper controls and randomization are required to establish its superiority when added with neoadjuvant chemotherapy over the current management of choice, which is chemotherapy alone. Further studies are required before establishment of any survival benefit in metastatic pancreatic carcinoma, and such evidence is lacking at present.

Keywords: Irreversible electroporation; Locally advanced pancreatic carcinoma; Metastatic pancreatic carcinoma; Advanced pancreatic carcinoma; Chemotherapy

Core Tip: Irreversible electroporation (IRE) is a non-thermal ablation technique that may increase survival for locally advanced pancreatic carcinoma when combined with chemotherapy. However, its efficacy in metastatic pancreatic carcinoma with liver metastasis is not yet established. Further high-quality studies with proper controls and randomization are needed. IRE can preserve neighboring structures and avoid the heat-sink effect, but it requires careful patient selection and has potential complications. The procedure is typically performed under general anesthesia and has several contraindications. While IRE may offer a new frontier in treating pancreatic cancer, its role in metastatic disease requires more research to confirm its benefits.